For more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.
Almost every day I read or hear about someone proudly that they have a “healthy” diet because they don’t eat butter, cheese or red meat or any other foods high in saturated fat (nevermind that red meat isn’t particularly high in saturated fat, but that’s a subject for another post). Or I might overhear someone at the grocery store saying how much they prefer whole fat yogurt to the low-fat version, but they eat the low-fat stuff anyways because they want to make the “healthy” choice.
What most people don’t realize is that it took many years to convince people that eating traditional, animal fats like butter and cheese is bad for you, while eating highly-processed, industrial vegetable oils like corn and soybean oil is good for you. This simply defied common sense for most people. But the relentless, widespread campaign to discredit saturated fat and promote industrial oils was eventually successful.
Well, that’s what I’m telling you. We’ve been duped. Lied to. And we’ve suffered greatly as a result. Not only have we suffered from being encouraged to eat packaged and processed foods made with cheap, tasteless vegetable oils and refined carbohydrates (low-fat cuisine), but these very foods we were told would protect us from heart disease actually promote it!
The recent review I’m talking about is a meta-analysis published this week in the American Journal of Clinical Nutrition. It pooled together data from 21 unique studies that included almost 350,000 people, about 11,000 of whom developed cardiovascular disease (CVD), tracked for an average of 14 years, and concluded that there is no relationship between the intake of saturated fat and the incidence of heart disease or stroke.
Let me put that in layperson’s terms for you:
Eating saturated fat doesn’t cause heart disease.
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There. That’s it. That’s really all you need to know. But if you’d like to read more about it, John Briffa and Chris Masterjohn have written articles about it here and here.
I wonder how long it will take for this information to trickle down into the mainstream culture? Unfortunately it’s not going to happen overnight. Paradigm shifts don’t work that way. But I’ve seen some positive signs, and I do believe the tide is turning. Let’s hope it doesn’t take another 50 years.
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I have no idea how you go from a controversial study on saturated fat to saying it is great to eat meat, butter and cheese but please show me one long-living healthy culture that survived primarily on meat, butter and cheese????
Explain how the Abkhozia, Vilcabama, Hunza, Okinawans and Tarahumara were so healthy on a whole plant-based diet that varied among them from 85% to 99%.
Richard you are speaking to the wrong group. I don’t mind coming on here posting because it is almost entertaining for me when someone refers me to an “article’ written by another person who is as lost as they are. The real data is not clear because it is difficult to do actual Randomized Controlled Trials when it comes to diet. Most rely on “recall” and that can be terrible when it comes to quantifying saturated fats and PUFAs. The more reliable data comes from people following specific diets like mediterannean, or vegetarian or vegan because then recall is less influenced figuring out meat content. For instance if you said you eat 10 oz. of steak 3 times a week. How much saturated fat is that? Depends on the type. Was it grass fed? Hormones? gets complicated. The data we have on vegetarians vegans pescetarians and metiteranneans is clear (but still not all are RCTs) that they reduce heart disease and cancer.
Your comment about the data on epidemiology is absolutely spot on. Every bit of epidemiological evidence we have suggests that groups of people who eat highly plant based diets with little meat tend to live longest. Many people want to point to ancient people who may or may not have eaten as they believe. In other words the data they have is very sketchy and not evidenced based at all. Coronoary heart disease has been around since man has been on this planet. It is worse now but it is NOT new. Same with cancer and so on. Take a look at the HORUS study. Some point to inuit and others but the data is only now coming to light that what we thought we knew just aint so. Most of these people never lived long enough to develop disease. In medical school (early on) we had this handout on world life expectancy, cancer deaths etc and we were asked what the healthier place to live was. I chose a small location in Africa because they had almost no deaths from cancer. Turned out the average life expectancy was in the low 30’s and their community didn’t keep good data so if someone died from cancer it probably wasn’t compiled in the data. The point is to know the information you are looking at and know what it means. I have a post above about the “nail in the coffin” with the most recent trial. There is way more to it than I wrote, but those are some of the numbers.
Wow, very interesting article. My husband and I have switched to coconut oil and real butter within the last 2 years as I read myths that canola oil and low fat butter were better for you. Sad thing is, I fell for the lie and our bodies cant break down all the chemicals that all this low fat stuff has. I agree with this article 100%. I wish I was taught this in nursing school!
Yes, the Standard American Diet (SAD) is so healthy that 80% of the people are dying from cancer and heart disease while some cultures in the world live much longer and more healthy without the meat, eggs and saturated fat.
Given the large number of studies performed we still do not know what is making us sick specifically. We do know that most Americans over 40 show signs of heart disease…it likely is not the water they drink so I have to think it is the diet.
http://www.westonaprice.org/traditional-diets/guts-and-grease
The studies are there:
http://www.livestrong.com/article/396625-ketogenic-diet-brain-cancer/
People are always searching for excuses to eat all they want. Saturated fats and carbs in large amounts are both deleterious, both cause oxidation. People want to eat them in large amounts, so they rely on diets like ketogenic and extremely low fat diets. They both work at a certain extent, you can eat a lot of whole food carbs if you mantain your fat below 10%, and you can eat a lot of fat if you mantain yourself in a ketogenic state.
But this accounts for just one meal, both diets would lack nutrients you need. If you mantain yourself in a ketogenic state you have to consume less antioxidants presents in plant carbs, the same way when you make the Ornish and Esselstyn diet you lack vitamin B12, A and D, as well as the good fats, the best one being the good fats.
The zone diet for me is the one that get close to an ideal diet in terms of nutrition and keeping the oxidative stress under control. And because it has all the ingredients that makes a healthy diet, it needs moderation, cause too much carbs and too much fats cause oxidative stress.
We talk about “good” fats as if fat itself is a bad thing. Butter is good fat, unless the animal was fed crap. A crappy fed cow produces crappy dairy. We speak about canola oil as if it were nectar of the gods. Research how it is manufactured. Research the manufacturing of margarines. Seriously you may as well eat Vaseline. Cream, coconut oils even lard is what I seek out as a part of my diet. I also use almond, walnut and olive oils. Fat is the most important nutrient that we consume. So consume it, already.
http://www.westonaprice.org/traditional-diets/guts-and-grease
It’s pretty sleazy to use a study funded by the National Dairy Council to convince your readers that saturated fats are safe.
Along with the other studies funded by the Cattlemen’s association or the Egg Nutrition Council, the information you are giving is biased, deceptive and speaks volumes for your integrity (or lack of).
Dan, all you stated was your opinion. It just shows that you are a victim of mantras without facts.
What’s the ‘final nail in the coffin’ bit? The study to which you refer was neither conclusive or scientific. This was simply a cherry-picking exercise of other people’s work. There was no longitudinal or latitudinal work, they simply picked studies funded by animal agriculture to back up a conclusion they’d already decided on. It’s simply absurd to suggest that the overwhelming evidence of the deleterious effects of saturated facts can be set aside.
Okay Peter, do your own research and prove this wrong.
http://www.westonaprice.org/traditional-diets/guts-and-grease
Peter you are correct to question the people who jump on a boat going in the opposite direction. There is no “nail in the coffin” and nobody on here will provide you any good research clearly demonstrating that a high saturated fat diet is good. First lets look at the study. As many on here know there are man questions about the data and there were a few errors in the data when they initially presented the study that have not yet been corrected. However, the problem with this study is that it is a Meta analysis and they are fraught with errors (not all the time). I can go into this much more if needed. You will never get anywhere with mary who posts small articles by persons with agendas mixed with half facts (how about the fact that most american indians didn’t live past the age of 35 and very very few lived past the age of 50.)
However, lets take the study at face value. Here is what it showed.
The risk of diets high in saturated fats for coronary disease was 1.03 (that means a slight increase in the risk for coronary heart disease) for 1.0 for monounsaturated 0.87 for omega-3’s (that means a 13% less chance of CAD with a diet higher in omega 3s) 0.98 for omega-6’s. Now the problem with these numbers is that they don’t meet statistical significance. Meaning that even though the trend is exactly as we would have predicted (basically saturated fats are bad, followed by mono and omega 6 then with better outcomes with omega 3’s, certainly makes sense). However, since it didn’t meet the pre determined statistical significance we can’t say there is any difference. HOWEVER, we can say that there was a “trend” for saturated fats being bad followed by MUFA and then PUFAs. This is an important point because what tests are included in this meta analysis are important, makes it more difficult to meet a predetermined end point.
Lets look at the data more. Here was a study (one of the “nails”) from 2009 by Mente comparing many types of foods with CHD(heart disease). Here is what it showed. I will be using the Relative Risk (RR) which is what the numbers above were (basically the 1.06 in for saturated fats in the most resent trial suggests there is a 6% increase in the risk of heart disease with high saturated fat diets. essentially if your RR is below 1 it is good and above 1 it is bad) Here goes for this study.
Mediterranean diet RR = 0.66 (holy smokes!!! 34% chance of less heart disease with a low saturated fat high nuts and such diet.) — this did meet statistical significance!
Monounsaturated fats RR = 0.81 (19% reduction and it met statistical significance)
Whole grains RR = 0.8 (20% reduction) and it met statistical significance
Fruits RR = 0.82 (significant)
Omega 3’s = (excluding ALA) = 0.86 (significant)
Saturated fatty acids = 1.06 (not statistically significant)
There are many trials like this one. Most demonstrate or clearly prove that mediterranean diet is good, substituting polyunsaturated fats (preferably omega 3) for saturated fats decreases heart disease AND if you substitute carbohydrates for saturated fats it is a BAD idea.
With regard to the “nail in the coffin” there is no nail. Look at the data and ALL the trends are clear. Increased saturated fats in the diet is bad. There is NOT a trend at all for improvement in health with saturated fats.
Peter I really just picked a couple of studies. I can provide a tremendous amount of empirical data as well as personal (anecdotal, which is the worst worst worst sort of data) data
Never eaten margarine always eat butter. My sister has a very healthy heart and we eat what we want.
Like anything “moderation” is the key. I gave up white breads and rice years ago as well if I do use sugar in anything and I cook my meals from scratch it is taw organic unrefined sugar.
I don’t put a lot of weight in certain studies as it is the large corporations who usually fund research to get the results “THEY” want.
All the people who try to watch their diets it might be a good idea if they put down the diet soda and sweeteners with Aspartame it is far worse than Satfats!
Hey, I noticed that your article posts no longer have a date on them. It would be great to get the dates back on these articles so I know how fresh this info is. Thanks.
What about the structure of the fat itself? From a chemical standpoint, saturated and trans-unsaturated fats have a higher tendency to stack on top of each other thus increasing the intermolecular forces between the fat molecules. The linear shape of these molecules allows them to stack upon one another with a high affinity. This stacking of the fat molecules leads to the build up in your arteries. Most unsaturated fats are in the cis conformation, this introduces a kink into the molecular structure of the fat, which decreases these intermolecular interactions and therefore decreases the extent of molecular stacking. Just from this understanding of the chemical structure of fats it would make sense that saturated fats and trans fats help increase one’s risk of coronary heart disease. What say you about this?
I am not a scientist…I am an observationist. Observe cultures who rely on a fat laden diet. See how they have thrived in health. Check out traditional diets of Native Americans, Inuits and Aborigines. Then tell me how can science assume that fat is bad? Especially when most consider a high carb low fat diet as being ideal, yet have to deal with weight issues. Most heart attack victims have normal or even low cholesterol levels. What does science say about that? As I look to my own dietary liestyle…I’ve had a ketogenic diet for 14 years. Scientifically I should have died 60 years ago
http://en.wikipedia.org/wiki/Inuit_diet#Perceived_benefits_of_the_diet
I am totally on board with the idea that saturated fat doesn’t cause heart disease. However, I am torn when it comes to other types of disease. I’m sorry that I don’t have any specific examples of studies, but I’ve heard about increased risk of disease such as cancer and other negative health effects with higher saturated fat intake. I’m not sure about the validity of these studies though. Could you provide some insight?
Hi Kim,
This is an interesting study.
http://download.cell.com/cell-metabolism/pdf/PIIS1550413114000655.pdf?intermediate=true
Worst effects look to be from high protein, low carb, but high fat, low protein didn’t fair much better.
Opponents of this info will claim that mice aren’t good to study because they have totally different diets than humans, claiming they are herbivores, but I would beg to differ:
http://www.ehow.com/about_6560397_wild-field-mouse-diet.html
Cancer thrives on glucose. Sugar feeds the cancer cell. Ketones starve it. Sugar is inflammatory in is central to most diseases. Sugar is a glorified poison. Sugar is well known for it’s ability to cause cavities…cheese, on the other hand , is well known to fight cavities. Looking at those from the view of your teeth alone, what is healthier to consume?
Is breast milk bad for infants? Of course not. Breast milk is the best food for an infant. What is in breast milk that is so beneficial? Saturated fat and cholesterol!
Cholesterol is part of every cell membrane. Cholesterol is a major component of myelin which protects nerves from damage. The highest concentration of cholesterol in your body is in your brain!!
All of your sex and adrenal corticol hormones are made from cholesterol
Vitamin D is made from cholesterol.
Multiple studies show that after the age of 65, the higher your cholesterol level, the longer you live
Saturated fats increases HDL
Unsaturated fats decrease HDL
The active ingredient in fish oil is omega 3 fatty acids – the active ingredient in snake oil is omega 3 fatty acids. Therefore fish oil = snake oil !!!!!!
Fish oil raises LDL cholesterol. Fish oil lowers your triglycerides by causing liver damage.
I could go on and on giving you more facts (none of the above is opinion)
Bottom line – the notion that saturated fats cause disease was made up by the food companies to sell vegetable oils and perpetuated by the drug companies to sell drugs and further perpetuated by supplement companies to sell fish oil
I really feel sorry for all of you who are committed to believing that saturated fats are bad for you. The has never been any conclusive proof that it is linked to heart disease. As a matter of fact, your liver produces more bad cholesterol that you can ever eat in a day.
On top of that I am living proof that saturated fats don’t hurt you. I am a 30 year old male, I work our regularly, I stay away from processed foods, I am at 6.5% body fat, I eat 3 whole eggs every day along with bacon, milk and red meat a few time a week.
The problems lie with the idiots that eat margarine and other processed foods. Try linking your health to the nature of the foods you eat. The more natural it is, the healthier you become from eating it. Try looking at the ingredients labels on the foods you do buy. The fewer ingredients, the better.
All in all, if you have high blood pressure or terrible cholesterol, blame the pre-packaged crap and not the saturated fats. They are essential to optimal health.
Hi Matt,
Thanks for the info. I am a nutritionally oriented doc and always interested in real life experiences of patients, etc. Would you be interested in “proving it” by doing some detailed lab testing to clarify that your insides look as good as your outside does? If so, contact me through my website drdanielchong.com and I can help you set up the testing wherever you are. As long as you have health insurance, it would be less than $50 or so, paid to the lab. At the very least it is always good to get some lab work done and check up on yourself periodically. You are at the perfect age to begin doing so. Let me know!!
The study cited is of little use to show any meaningful connection between saturated fat and heart disease. The energy from saturated fat in the various studies ranged anywhere from 7% to 17%. That is just from saturated and doesn’t account for other fats, therefore the total percent calories from fat is probably 30%+. I could tell from Table 3 in the study that no meaningful conclusion would be reached. Modest changes in saturated fat intake are unlikely to produce any significant changes in risk.
Chris says that there is no evidence on the connection between saturated fat and heart disease, yet a simple search of PubMed reveals many studies finding an association between saturated fat and impaired endothelial function.
I don’t understand how he can come out and say “case closed” and announce that saturated fat has no association. At this point in time, we haven’t seen enough conclusive evidence to prove either side.
It seems the tendency is to call any study finding no association a “good” study while continuing criticizing all the rest.
Adam: “The study cited is of little use to show any meaningful connection between saturated fat and heart disease. The energy from saturated fat in the various studies ranged anywhere from 7% to 17%. That is just from saturated and doesn’t account for other fats, therefore the total percent calories from fat is probably 30%+. I could tell from Table 3 in the study that no meaningful conclusion would be reached. Modest changes in saturated fat intake are unlikely to produce any significant changes in risk.”
Remember that the burden of proof lies on those who claim that saturated fat is harmful. Creating a bunch of ad hoc explanations of why every saturated fat study do not find an association is irrelevant, because it is not evidence of anything.
Adam: “Chris says that there is no evidence on the connection between saturated fat and heart disease, yet a simple search of PubMed reveals many studies finding an association between saturated fat and impaired endothelial function.”
Endothelial function is not heart disease, but a surrogate marker of unknown significance. Yes, saturated fat allegedly worsens every surrogate marker on the planet, yet strangely, when put to the test in long-term studies with hard outcomes, it fails…just about every time.
The evidence on endothelial function is actually inconsistent, and the marker is highly context dependent. There are many studies showing antioxidants improve endothelial function, but little evidence to show that antioxidants reduce cardiovascular events. Changes in surrogate markers do not necessarily translate into risk reduction, which is why studies on hard outcomes need to be done and have already been done.
Adam: “I don’t understand how he can come out and say “case closed” and announce that saturated fat has no association.”
Because saturated fat has no association. How many times do you want to keep flogging a dead horse? If you’ve searched for something long and hard but failed to find it, the only logically conclusion is that it is probably not there i.e. saturated fat is not harmful.
My Granddad´s brother worked for 40 years in a farm and he was accustoemd to eat 24 whole eggs a day. 12 of it boiled, the rest was fried on a home made bacon. He died in the age of 82 years. He has never had any problems with high cholesterol or a heart attack. I eat several whole eggs a day too and I eat some 50-100g of home made smoked bacon too. I am a blood donor and docs check out my blood regularly. I am 100% healthy. Maybe because of my genetics, maybe because of the food I eat, maybe cause I do my workout with barbells and kettlebells, or combination of it. I don´t eat bread, I only eat time-to time noodles in a soup some buckwheat and home made potatoes (about 50g a day) I feel great and I am in great shape. I am 190cm tall and 98 kg heavy. When I used to eat oats and cereals I was fatty and sleepy. No I want to “lift up” the Earth, but it doesn´t have ears to grip. 😉
My wife had an aunt that smoked well into her 70s. She began smoking at an early age (early teen years). She lived to 99 years of age. You don’t hear me going around recommending people smoke because it didn’t affect my wife’s aunt.
Why did she stop?
Yea, the guy totally lost me on the “China Study” being called essentially bogus. I spent years watching my dad telling people to give up meat and animal products and having their diseases go away. Hundreds of people came to my dad and got similar positive results for heart disease and everything else.
The truth is the Paleo diet hasn’t been around nearly as long as vegetarianism has. And before you start that nonsense of it being around for 2.5 million years, that’s a joke. Paleolithic people didn’t eat the fruits and vegetables we eat today, and they didn’t eat the animals we eat today either. The entire “science” behind it is baloney. The statement that we can’t eat grains and legumes and lentils because our body hasn’t “evolved” over 10,000 years is pure conjecture. Vegetarians who don’t eat meat for 60 or 70 years and then eat a little meat often times get very very sick. If a person can develop an ability to digest meat without ill effects, or lose that ability over 50-70 years, Human Beings can learn to digest grains over 10,000 years.
The Paleo diet isn’t supported by science. It’s supported by body builders who want a justification for high protein diets, wild theories about what Paleolithic people were like that most Archaeologists disagree with, and peddled by a few doctors to make money.
I was a vegetarian but still ate lots of dairy and eggs in my life. I had high cholesterol. I completely cut milk and cheese out of my diet and within 6 months my cholesterol went down to normal levels with no medicine or other dietary changes.
Saying Saturated Fats or Animal Products don’t have a relationship to cholesterol is a joke.
Hold on, wait a minute, did you really link to the Siri-Tarino study that was supported by the National Dairy Council, with scientists funded by Unilever (a maker of margerine and ice cream) as well as National Cattleman’s Beef Association?
If there’s anything more obviously funded by special interests, I haven’t seen it, and that’s your research?
The Paleo diet is one of the least healthy diets as measured by experts – http://www.cnn.com/2014/01/07/health/best-diets-ranked/
Unfortunately some doctors, referencing studies funded entirely by dairy and meat special interests are attempting to beguile a nation that wants so desperately to believe that eating saturated fats are good. You’re not the first guys to do this schtick, Atkins tried it.
Hi Vahagn,
The truth is, the “Paleo Diet” as it is used these days in the media and amongst its followers is really a misnomer. A true Paleolithic diet cannot be replicated in this age due to the environment, food quality, toxins, lifestyles, etc. Even modern hunter/gatherers can’t fully replicate a Paleo lifestyle, although they would come closest to doing so. They really ought to rename it to something else. Essentially it is a non-grain, non-dairy, whole-foods diet but that doesn’t sound very catchy as a name.
I remember seeing some slides regarding a study that was done on a hunter/gatherer group and the average monthly kill quota was one large sized animal per month. Our ancestors of that era, like their more modern counterparts of today, would have relied a lot more on plant foods, insects, fungus (mushrooms), fruits and nuts (when available), lizards, small rodents, fish and amphibians (depending upon their proximity to water sources), birds, eggs and last but not least – tubers.
Personally, my diet is highly plant-based, supplemented with fish several meals per week. I also take fish oil supplements. I rarely use oils of any kind in cooking. I think I may have a problem sticking to a vegan diet, although I have done it for a few months at a time. I used a lacto-vegetarian diet to lower my cholesterol but the dairy products were non-fat milk (skim) and non-fat Greek yogurt. I was also supplementing with phytosterols.
I see that you decided to drop eggs (I fully understand that) as well as dairy. Did you not consider non-fat dairy as an alternative? Currently, I am making the switch from dairy to almond milk. Dropping cheese was extremely difficult. At least, in my case it was.
Cheers,
Rob
It’s about the sugar. Also – remember the Omega 6’s and 3’s compete for their place in our bodies. In an optimal state 6’s and 3’s are balanced. Too much sat fat drive’s the 3’s down.
3’s are probably the better of the two – so best not to drive them down. It’s about the sugar! And, just because it’s not sweet – doesn’t mean it is not sugar or recognized by our bodies as pretty much the same thing. Get the sugar, carbs, and refined garbage out – and your vascular disease (it’s really vascular disease – NOT heart disease (that is – until it the lack of blood flow caused by vascular disease starts killing heart tissue.) will reverse. (another caveat here is type 2 diabetes – if you are close to or already past a diagnosis – reversing your vascular disease can become a more challenging scenario.)
I got rid of range of health issues when I switched to a raw vegan eating regimen. I began eating 2500-3000 calories before 3pm everyday of fresh uncooked fruit and vegetables. After 3 i would eat a cooked meal for dinner and within a few days I no longer suffer from reflux. My eczema cleared up after about 6 weeks.
After about 6 months of this regimen, I then stopped consuming animal protein altogether, and that is when I really noticed huge improvements in my energy levels. I am not against meat eating or “paleo”, but I have seen the benefits to plant-only eating in my own health and for that reason I won’t be going back to meat again.
Great article, and interesting comments!
I’d like to know more about your beliefs on the correlation between LDL cholesterol levels and heart disease. It seems to be coming evident that it’s the inflammation (causing arterial damage) that is the issue as opposed to the cholesterol levels.
-Adam
Adam – if you still frequent this thread and are looking for more answers – research all you can about actual Low Density Lipoprotein particles and particle number. The entire story is likely one about the particles that transport cholesterol in our bodies (Low Density and High Density Lipoprotein particles) and less about the hormone cholesterol itself.
HIgh sugar consumption will bring about changes in your hepatic (liver) function hence regulating the number of damaging particles up in our bodies.
The study mentioned in this article has been criticized for its methods, including the original studies being imprecise, the lack of consideration of replacement of saturated fats with polyunsaturated fats, and not using unadjusted data. I suggest http://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascular_disease_controversy for further reading if anyone is interested in actually seeing a variety of responses on this issue (the study in question here is Siri-Tarino, 2010).
Hi Chris,
Hard to argue with the finding of this study, at least when we consider the question- Does saturated fat intake cause heart disease? But does that mean it is good for us and doesn’t correlate in some way? What about, for example, when we look at endothelial function and saturated fat intake, or total fat intake at a meal? The findings below do not suggest an argument countering the findings of the study you mention here, but they do suggest that saturated fat intake maybe harmful to endothelial function and thus undesirable, at least for those of us who want good endothelial function. If someone has cardiovascular disease (for whatever reason) it appears from the studies below, that they would be in more dire straits after a high saturated fat meal. In other words, saturated fat may not cause heart disease (as we know the true cause or causes are multifactorial) but it sure doesn’t look like it would help.
http://content.onlinejacc.org/article.aspx?articleid=1137827
http://www.ncbi.nlm.nih.gov/pubmed/14561213
http://www.nature.com/ijo/journal/v37/n2/full/ijo201242a.html
These findings match closely the findings of a study comparing Atkins and Ornish diets, where blood flow and arterial health (endothelial function) were measured using brachial artery reactivity testing (BART), also known as flow-mediated vasodilation, a well-accepted direct measure of arterial health and a validated predictor of cardiovascular events. Blood flow worsened on the Atkins diet, and there was a significant inverse correlation between intake of saturated fat and total fat and worsening of blood flow.
http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_819?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Ornish&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
The study below, meant to investigate the effect of flavonoid consumption on endothelial dysfunction, even used a high fat meal to cause the problems they were hoping the flavonoids would then help with (which they did)
http://www.hindawi.com/journals/ecam/2011/796958/
I guess my point is that the take home message and feel of your post here is that we shouldn’t worry about saturated fat intake and heart disease. Considering what I mention above, I feel we are far from being able to make such a definitive statement.
Dr Chong,
After reading the study of Atkins and Ornish diets, I have to suggest that those on the Atkins diet will have been required to eat far more than they would normally, and certainly more than their body required and their appetite ‘told’ them to eat.
Of course I understand that the study was trying to isolate the effects of fat intake without weight loss being taken into consideration, but all this did was throw in another variant, as those on the Atkins diet were basically forced to eat more than they needed whilst those on the Ornish most probably weren’t.
During the study “They (participants on both diets) were weighed weekly and caloric adjustments made if weight change exceeded 1 kg”, and I know from experience that when undertaking the Atkin’s Diet, weight loss would far exceed 1kg every week even after induction, even when the appetite is quenched, and indeed we tend to not even count calories when on the Atkins.
It could just as well be concluded from this study that subjects who are forced to eat significantly more than their appetite requires them to have worstened blood flow when compared to those who eat more in line with what their appetite requires them.
Finally, one of the conclusions of this study states that “In the absence of weight loss, the high fat Atkins diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis…..”
When weight loss is pretty much a guaranteed benefit of a low-carb diet, with the associated health benefits of weight loss, I can’t help but think that this study is worthless when considering the actual effects on blood flow of anyone undertaking the Atkin’s diet.
It’s a bit like suggesting that a diet of burgers, crisps, candy, soda drinks and 100% processed meals isn’t really all that unhealthy for us…….in the absence of weight gain.
Hi Chris,
Great comments and observations. Unfortunately, because a similar study wasn’t done where participants were allowed to eat as little as they wanted and to lose as much weight as they naturally would on such a diet, I guess we won’t know for sure. Your point does beg the question (which has been raised before) though of how much benefit from an atkins low carb style of diet is simply subsequent to the reduction in calories and not the composition of macronutrients. That all said, my biggest point in my original point had more to do with potential concerns for the direct impact of saturated fat on endothelial function. While the Atkins/Ornish study may not have been the best designed study to assess this issue, the other studies seem to be pretty clear. Therefore, I’m still interested in the Ornish/Atkins study.
Dr Chong,
I think the Ornish/Atkins study demonstrates once again just how difficult it is to actually design studies from which definitive conclusions can be reached.
Even when studies are able to prove apparently adverse health effects, we can often find studies demonstrating positive effects on health leaving the reader to ponder if the positives outweigh the negatives or vis verse; it seems very little is clear cut.
With the Atkins Diet, as you yourself ask, are any benefits due to the reduction in calories or are they due to the composition of macro nutrients?
In a similar vein, I would ask if it’s the addition of more fats/protein to the diet which brings benefits, or the reduction in carbs/sugar, or the reduction in processed meats, or the reduction in Omega 6, or the increase in Omega 3 and subsequent equalisation of Omega 6 and Omega 3?
Although I follow a low carb diet myself I know I can’t claim it’s the low carbs aspect which benefits me most, as it may well be the fact I don’t now eat any tinned food and only eat fresh produce, and more fish etc.
Is it what I’m now eating that benefits me most, or what I’m not now eating?
Obviously there would need to be multiple studies to look at each of these variables in isolation, and even then other variables would be introduced meaning the number of participants would have to be very large to try and enable the variables to be accounted for.
At the end of the day however, if saturated fat was definitely ‘bad’ for us in general, it would have been proved by now, and the fact you and Chris can provide opposing evidence in the form of peer reviewed studies does indicate to me that whilst there may be positives and negatives to saturated fats, there is no one aspect which we can point at to demonstrate they are in general to be avoided.
On the other hand, we can only eat a finite amount of food, if we don’t eat foods containing saturated fats (which tend to be unprocessed) there’s every chance we will instead be eating processed foods high in Omega 6 which we do know are harmful in the long term, because millions follow this western diet and we can see the results.
Often it is the case that diets are changed when the damage has already been done, and any improvements in health are of course attributed to the new diet whether it is low carb or low fat, but the reality probably is that it’s simply the cessation of eating their former diet which is causing the improvements, and a change to a diet of bread and water would also yield rewards.
Hi Chris,
That was so incredibly well put. Maybe you should write a blog. I’d read it!
It’s so interesting really. i have been exploring these types of questions about saturated fat (and also low carb/high carb, paleo/vegetarian/vegan, etc, etc) for the last 13 years now and still don’t believe there is a definitive answer. I think the only definitive answer (and I know Chris Kresser feels the same way) is that there are individual differences that will make one person more or less likely to tolerate something than the next person is. However, your point about people possibly benefiting from one diet or another having more to do with what is taken out vs what is still included is such a good one too and should definitely be considered the likely explanation in most cases. That all said, these days I am looking more and more at other things that I feel are very, very under-recognized in the paleo and low carb worlds and that has to do with food as a toxin source, and which foods contain the least. I do not mean things like lectins and phytic acid which some believe are toxins. I am talking more about the nasty ones like PCBs and dioxins. While I do feel some will do best on a LCD, I am growing more and more reluctant to recommend them to my patients and clients because of the fact that animal foods (especially fats) are the most significant route of exposure (http://www.ejnet.org/dioxin/). I am all but certain that, if it does turn out there is a connection between animal fat and cancer, it has more to do with this issue than any other. I am also starting to explore more and more the impact that factory farming has on our environment and it is becoming harder and harder to deny the issue. I am no expert, so I’m sure some out there will disagree with reputable sources to back it up. But what I’ve read is hard to argue with. Sure if we did farming and livestock raising the right way we wouldn’t have near the impact, but when is that going to happen? Add to that the horrendous conditions the animals are in, the contribution the huge amounts of antibiotics used are making towards creating resistant bacteria and we have some huge, huge problems with very few solutions. I’m to the point these days where I just try my best to consider all of these issues. At the same time, I still have patients sitting in front of me in my office, or talking to me on a phone from somewhere, and they want answers to the question of what ails them. Not an easy one to give. I’ll keep doing my best though!!
There’s a very informative link I’ll provide at the end of this short message which includes quotes from various sources regarding the ‘Inuit paradox”, and the point is made that even though they eat more meats and fats than Westerners, their saturated fat intake is probably lower.
Nods are also given to the Omega 6 to Omega 3 ratio of the western diet compared to the Inuits, so once again we can’t draw definitive conclusions on individual aspects of the Inuits diets although certain aspects do ‘strongly suggest’ correlations only the most pedantic cynic would ignore.
In a similar vein to what I’ve said before then, is it the high fat, high protein diet (which includes animal organs) which apparently protects the Inuits from heart disease and cancers, or is it the almost total omission of sugar?
http://www.theiflife.com/the-inuit-paradox-high-fat-lower-heart-disease-and-cancer/